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Mechanisms of Resistance

Surveillance of Carbapenem-Resistant Pseudomonas aeruginosa Isolates from Puerto Rican Medical Center Hospitals: Dissemination of KPC and IMP-18 β-Lactamases

Daniel J. Wolter, Noha Khalaf, Iraida E. Robledo, Guillermo J. Vázquez, Maria I. Santé, Edna E. Aquino, Richard V. Goering, Nancy D. Hanson
Daniel J. Wolter
1Center for Research in Anti-Infectives and Biotechnology, Creighton University School of Medicine, Omaha, Nebraska
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Noha Khalaf
1Center for Research in Anti-Infectives and Biotechnology, Creighton University School of Medicine, Omaha, Nebraska
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Iraida E. Robledo
2University of Puerto Rico School of Medicine, Department of Microbiology and Medical Zoology, San Juan, Puerto Rico
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Guillermo J. Vázquez
2University of Puerto Rico School of Medicine, Department of Microbiology and Medical Zoology, San Juan, Puerto Rico
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Maria I. Santé
3University of Puerto Rico School of Medicine, Department of Pathology and Laboratory Medicine, San Juan, Puerto Rico
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Edna E. Aquino
2University of Puerto Rico School of Medicine, Department of Microbiology and Medical Zoology, San Juan, Puerto Rico
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Richard V. Goering
4Creighton University School of Medicine, Omaha, Nebraska
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Nancy D. Hanson
1Center for Research in Anti-Infectives and Biotechnology, Creighton University School of Medicine, Omaha, Nebraska
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  • For correspondence: ndhanson@creighton.edu
DOI: 10.1128/AAC.01172-08
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    FIG. 1.

    PFGE of the 37 isolates analyzed. The names and PFGE types of the isolates are shown at the right of the figure. The dendrogram depicting genetic relatedness and generated using BioNumerics is shown at the left of the figure. The scale for the dendrogram represents percentage of relatedness. Staphylococcus aureus strain NCTC 8325 was used for the gel-to-gel normalization required to generate the dendrogram.

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  • TABLE 1.

    Characteristics of the P. aeruginosa isolates from Puerto Rico

    StrainSample siteHospitalaHospital wardbPFGE groupMIC (μg/ml)cPCR resultdpISequence analysiseExpression off:OprD productiong
    P/TCAZIPMMEMIMPVIMKPCOXAmexAoprD
    PAO14110.51.01.0+
    PS1Sputum1General9C82168NegNegNeg4.20.008
    PS2Urine1ICU10B41286416PosNegNegPos8.0IMP-18, OXA-2
    PS3Sputum2ICU1284168NegNegNeg1.00.002−
    PS4Sputum3General9B64>128>6464PosNegNegNeg5.4, 7.5, ≥8.5IMP-18
    PS5Sputum1ICU7A>25664>64>64NegNegPosNeg6.7, ≥8.5KPC-21.80.005−
    PS6ASputum4ICU11A>25632>64>64NegNegPos1.80.0005−
    PS7AUrine4ICU11D>25664>64>64NegNegPos
    PS9Sputum1General3B648816NegNegNeg
    PS10Blood1General1A>25664>64>64NegNegPosNeg6.7, ≥8.5KPC-21.50.003−
    PS11ASputum1ICU7A>25632>64>64NegNegPos
    PS12Sputum1General7B>25664>6432NegNegPos
    PS13Sputum1ICU11E>25664>64>64NegNegPos
    PS14Sputum1ICU10C4646416PosNegNeg
    PS15ABlood1General10A81283216PosNegNeg
    PS17BBlood1ICU11D>25664>64>64NegNegPosNeg6.7, ≥8.5KPC-22.00.0004−
    PS18ACSF1ICU11D>25632>64>64NegNegPos
    PS19AUrine1General11C>25664>64>64NegNegPos
    PS20ASkin5General11D>25664>64>64NegNegPos1.90.0003−
    PS21Skin4General11F>25664>64>64NegNegPos
    PS22Urine4General3A25616816NegNegNeg
    PS23Blood1General4A>256128>64>64NegNegPos6.7, ≥8.5KPC-2
    PS25Sputum1General1A>25664>64>64NegNegPos
    PS26Sputum3ICU3A1288816NegNegNegPos7.5, 8.0OXA-2
    PS28Skin5General6128128>64>64NegNegPos7.65, ≥8.5KPC-5
    PS29Sputum4General11D>25664>64>64NegNegPos
    PS30Sputum4General11D>25664>64>64NegNegPos
    PS31Skin4General11B>25664>64>64NegNegPos
    PS33Blood1General9A32>1286432PosNegNeg
    PS34Blood1ICU4A>25664>64>64NegNegPos
    PS35Urine4General11A>25664>64>64NegNegPos
    PS36Urine4General11B>25664>64>64NegNegPos
    PS37Sputum4General11D>25664>64>64NegNegPos
    PS39Urine1General8128>128>6464PosNegNegNeg5.4, 6.0, 7.5, ≥8.5IMP-184.10.015−
    PS40Urine6General512832>64>64NegNegPosPos6.7, 8.0, ≥8.5KPC-2, OXA-2
    PS41Urine4General11D>25664>64>64NegNegPos
    PS43Skin1ICU2256161632NegNegPosPos6.7, 8.0, ≥8.5KPC-2, OXA-21.80.56−
    PS44BloodERNR1332>1286432PosNegNegNeg5.4, 6.0, 7.5, ≥8.5IMP-183.30.36−
    • ↵ a ER, emergency room.

    • ↵ b ICU, intensive care unit (includes medical, surgical, pediatric, and neurosurgical units); NR, not reported.

    • ↵ c P/T, piperacillin-tazobactam; CAZ, ceftazidime; IPM, imipenem; MEM, meropenem.

    • ↵ d Neg, negative for amplification; Pos, positive for amplification.

    • ↵ e The blaKPC and blaIMP-18 sequence represents the entire structural gene. The blaOXA-2 sequence was obtained from 555 bp of the amplified fragment.

    • ↵ f Expression data are presented as fold differences compared to the wild-type strain PAO1.

    • ↵ g OprD production was assessed by outer membrane analysis.

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Surveillance of Carbapenem-Resistant Pseudomonas aeruginosa Isolates from Puerto Rican Medical Center Hospitals: Dissemination of KPC and IMP-18 β-Lactamases
Daniel J. Wolter, Noha Khalaf, Iraida E. Robledo, Guillermo J. Vázquez, Maria I. Santé, Edna E. Aquino, Richard V. Goering, Nancy D. Hanson
Antimicrobial Agents and Chemotherapy Mar 2009, 53 (4) 1660-1664; DOI: 10.1128/AAC.01172-08

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Surveillance of Carbapenem-Resistant Pseudomonas aeruginosa Isolates from Puerto Rican Medical Center Hospitals: Dissemination of KPC and IMP-18 β-Lactamases
Daniel J. Wolter, Noha Khalaf, Iraida E. Robledo, Guillermo J. Vázquez, Maria I. Santé, Edna E. Aquino, Richard V. Goering, Nancy D. Hanson
Antimicrobial Agents and Chemotherapy Mar 2009, 53 (4) 1660-1664; DOI: 10.1128/AAC.01172-08
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KEYWORDS

carbapenems
Pseudomonas aeruginosa
beta-lactamases

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